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Accidents can happen. You can do everything right and be so careful but sometimes the condom breaks, or he doesn’t make it out in time.

No method of contraception is 100% fool-proof (you have to remember to take the pill every day for it to be effective!)

So let’s talk about your options for emergency contraception if you’re currently using a method of birth control.

HERE’S WHAT WE COVER

• Understanding your cycle enables you to know if emergency contraception is truly needed
• Access to emergency contraception in Australia
• Emergency contraception options
• How emergency contraception works
• What to do next
• Will emergency contraception delay my period or impact my fertility?
• Side effects of emergency contraception
• Contraindications

EPISODE NOTES

Understanding your cycle enables you to know if emergency contraception is truly needed

Things happen. And so, if pregnancy is not an option for you then you may like to start thinking about your options for emergency contraception. This isn’t just limited to practicing natural birth control; all methods of birth control have a risk and nothing is 100% effective, except for of course abstinence. And this is obviously something that you need to think about if you’re sexually active and wanting to avoid pregnancy. This is probably something that’s thought about more as we get a little older and especially for those who do use natural methods of birth control. Young women being prescribed the pill likely aren’t getting the opportunity to have these conversations because hormonal birth control is considered fool-proof. And so it’s your responsibility to have a plan in place for that one time when shit happens. Maybe you forget to take the pill, or you throw up shortly after taking it. Maybe the condom breaks. Maybe he just doesn’t make it out in time.

I recently had a conversation about this very subject when someone who is currently charting her cycle and practicing natural birth control, and unfortunately her partner didn’t withdraw in time. And she wanted to know if emergency contraception was necessary. And it really got me thinking about this. whole day 14 ovulation myth we have been fed, and how asking that same question to a practitioner that subscribed to this myth could have serious consequences.

Say for example this incident, this whoopsie, happened on day 21 of your cycle. If you went to see a practitioner who went with the 28 day cycle, day 14 ovulation, way of thinking, they’d potentially tell you that you were fine. Because if you ovulated on day 14, you’re not still going to be fertile by day 21. But if you had a longer cycle and for whatever many number of reasons you ovulated later than expected, say day 17 or 18 or any day that isn’t day 14, but is later than day 14; you may well still be fertile on day 21 when this happened and pregnancy is absolutely possible. This is why understanding your cycle and when you are fertile is so important. And look, I’m sure most practitioners would err on the side of caution and recommend emergency birth control just in case, but you so absolutely want to know if it’s necessary or not.

Access to emergency contraception in Australia

I am of course extremely mindful that I live in Australia where we are fortunate to have over the counter access to emergency contraception and can get it quite easily, and I understand that this is not the case everywhere in the world. Access is limited and harder to come by in some places; sometimes you need a prescription which obviously takes more time to get a hold of the medication, and in some places it just isn’t accessible. This is why understanding your cycle is so important! So that you can know the likelihood of pregnancy according to when this accident happened in your cycle. Because I’m in Australia, I’m going to talk about the process and the most commonly available options in Australia, so please know that this will vary depending on where you live and it’s worth doing some research into the rules and regulations and availability where you live so that you don’t have to do a mad Google when you need the information. Planning ahead and having an idea now when there’s no urgency will set your mind at ease.

These types of medications are more effective the earlier you take them and so if you want to make sure you have easy access in an emergency, you might like to buy some in advance so it’s on hand if you ever need it. You may never need it, but it might be kind of nice to have it at home and ready for you if ever you did, and if you knew that pregnancy was not an option for you right now.

Emergency contraception options

The 2 main types of emergency contraceptive pill available in Australia are LNG and UPA and both are available in Australia without a prescription. LNG needs to be taken within 72 hours (or 3 days) of sex, and UPA can be used up to 120 hours (or 5 days) after intercourse. LNG is about 80-90% effective and UPA is 98% effective.

If you can’t access either of these pills, your other option is to have a copper IUD inserted within 5 days of sex. This is a long-term form of contraception so you can’t really just have it inserted then taken out again. But this is a legitimate and effective option if you can’t access emergency contraception where you live and you are prepared to use the IUD for birth control for a period of time afterwards.

How emergency contraception works

The sooner you take emergency contraception, the better your chances of avoiding pregnancy. They obviously contain artificial hormones and they work by stopping or delaying ovulation. So if taken before ovulation actually occurred, these medications prevent the surge of LH that stimulates the ovarian follicle to release an egg. They can also have an effect on your cervical mucus to make it more difficult for sperm to reach the fallopian tube. If sperm has already fertilised an egg, then the emergency contraception will not work because it has been taken too late. So, you can see how important it is for you to know where you are in your menstrual cycle and to confirm whether or not ovulation has actually occurred to know first of all if emergency contraception is required and whether or not it will be effective.

What to do next

After taking emergency contraception, you should make a follow up appointment with your doctor within about 3 weeks to discuss whether a pregnancy test is needed to check that the pill was effective, to get a screening test for STIs if needed and also to discuss your longer term contraception needs. It is especially important to speak with your doctor or a qualified health professional if you do not have a menstrual period within 3 weeks of taking emergency contraception.

If you’re breastfeeding, you should also avoid breastfeeding for 3 days after taking emergency contraception.

Will emergency contraception delay my period or impact my fertility?

The sudden dosage of hormones that prevent ovulation can have an effect on your menstrual cycle – we’re preventing a LH surge and blocking ovulation, after all – but it should regulate quite quickly. If it doesn’t, speak to someone for advice.

Side effects of emergency contraception

While both types of emergency contraception are considered safe with no serious long-term complications, many women will notice some side effects soon after taking emergency contraception. These may include:

• Fatigue
• Nausea and vomiting
• Stomach pain
• Diarrhoea
• Dizziness
• Headache
• Tender breasts
• Increased vaginal bleeding
• Skin reactions

Contraindications

There are also some significant contraindications and you should not be using emergency contraception under the following circumstances. It is best to always discuss your options with a pharmacist or doctor who is familiar with your individual medical history. So, while you can get these medications without a prescription, if you can see your doctor quickly, it’s best to discuss it with someone who knows you before taking them.

Possible contraindications include:

• Suspecting you’re already pregnant
• Taking other medications, particularly for epilepsy, tuberculosis, HIV, fungal infections or containing St John’s Wort.
• High blood pressure
• Diabetes mellitus
• Ischaemic heart disease
• History of stroke
• History of breast cancer
• Severe liver disease
• Gastrointestinal disease affecting digestion and absorption of food (e.g. Crohn’s disease)
• Vomiting or severe diarrhoea

Absolute contraindications include:

• Pregnancy
• Previous unprotected sex more than 72 hours earlier in the same menstrual cycle (may already be pregnant)
• Experiencing vaginal bleeding of unknown cause
• Breast cancer
• Allergies to any ingredient listed on medication packaging
• Tablets do not look quite right, have expired or packaging has been torn or tampered with.

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